ABSTRACT
Nonparasitic chyluria is rare. Spontaneous remission occurs in 50% of patients. Conservative treatment includes diet with medium-chain triglycerides, lymphangiography, and the instillation of sclerosing solutions of silver nitrate. If conservative management fails, open or retroperitoneoscopic nephrolysis is the treatment of choice. We present a case of spontaneous recumbent nonparasitic chyluria from the left kidney treated twice by endoscopic application of neodymium-YAG laser. This is new to the literature. The chyluria disappeared for several months. The temporary cessation of chyle flow after local laser application should encourage further use of this treatment modality after failure of conservative treatment.
Subject(s)
Chyle , Endoscopy , Fistula/surgery , Kidney Diseases/surgery , Kidney Pelvis/surgery , Laser Coagulation , Lymphatic Diseases/surgery , Urinary Fistula/surgery , Extravasation of Diagnostic and Therapeutic Materials/diagnostic imaging , Extravasation of Diagnostic and Therapeutic Materials/surgery , Female , Fistula/diagnostic imaging , Humans , Kidney Diseases/diagnostic imaging , Kidney Pelvis/diagnostic imaging , Lymphatic Diseases/diagnostic imaging , Lymphography , Middle Aged , Postoperative Complications/diagnostic imaging , Postoperative Complications/surgery , Recurrence , Reoperation , Tomography, X-Ray Computed , Urinary Fistula/diagnostic imaging , Urine , UrographyABSTRACT
UNLABELLED: We retrospectively compared perioperative donor outcomes and early complication rate of right- and left-sided retroperitoneoscopic living donor nephrectomy (RLDN). METHODS: From November 2001 to April 2006, we performed 118 RLDN. Including 24% (n = 28) right-sided RLDN and 76% (n = 90) left-sided RLDN. Perioperative results and the rate of adverse events were compared for both sides. RESULTS: We observed no significant difference in operation time, blood loss, warm ischemia time, or postoperative creatinine levels between right- and left-sided kidney donors. RLDN was successfully performed in 116 of 118 donors. One donor in each group had to be converted to an open approach. We observed one graft loss due to renal artery kinking in one recipient after left-sided RLDN. Two right donations needed a saphenous venous patch due to a short right renal vein (<2 cm). Overall, intraoperative and postoperative complications were comparable between the two donor groups. CONCLUSION: Right-sided RLDN provides comparable perioperative and postoperative results to those of left-sided RLDN. Our results demonstrated that groups with significant experience in RLDN can perform right living donor nephrectomy safely and efficiently with minimal invasiveness.